Using Routine Data in Combination with Population Surveys to Understand Patterns of Contraceptive Use: A Case Study of Malawi

Using Routine Data in Combination with Population Surveys to Understand Patterns of Contraceptive Use: A Case Study of Malawi
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Abstract: Routine data have often been underutilized in family planning (FP) program monitoring and evaluation and in decision making at local and national levels. This presents a critical need for a greater use of these data sources for health outcome monitoring and decision making. The overall goal of this exercise was to test the feasibility of using existing routine data in combination with non-routine data to monitor and explain contraceptive use behaviors among populations in need, while also assisting districts to better understand supply chain challenges and plan for commodity procurement. We aimed to achieve two specific objectives:

1. Assess patterns of modern contraceptive use and discontinuation for method related reasons among women of reproductive age

2. Compare modern contraceptive supply data among districts with different levels of contraceptive use and discontinuation for method related reasons to identify potential supply challenges and recommendations

Malawi was the focus country of this activity. Non-routine information on contraceptive behaviors among representative samples of women of reproductive age came from the last Malawi Demographic and Health Survey (DHS) in 2015–16 (National Statistical Office [NSO/Malawi] and ICF, 2017). Sources for routine data included District Health Information System 2 (DHIS2) and OpenLMIS, which have been integrated into the health management information system of the Ministry of Health. We focused on data related to the current use and discontinuation of injectables and implants (from the DHS), and their supply data from the HMIS. Supply data included indicators related to stockout, stock on hand, and quantities received and used.

The analysis was implemented in two phases. Phase I was the analysis contraceptive use and discontinuation among Malawian women using the DHS data. The intent of Phase II was to assess supply indicators for each of the eleven USAID priority districts. The key outcome of the exercise was to produce a simple analytical approach that could be replicable in other settings.

The exercise highlighted the critical need for data consistency and quality for this type of analysis to produce useful findings that could benefit decision making around commodity supplies. We propose certain recommendations to improve the usability of commodity supply data and enhance the feasibility and usefulness of this exercise. First, it is important to establish clear criteria with regard to what service delivery points and health facilities need to report on what indicators, and how. These criteria also need to clearly distinguish different community distribution mechanisms, i.e. facility-based versus community-based, depending on the specific method. Second, there needs to be an established feedback mechanism for the district and central levels to review and incorporate such data into commodity procurement and disbursement decision making. Such a feedback mechanism should allow sufficient time for the district and central levels to review data and take actions to enhance data quality.
Shortname: tr-22-472-D4I
Author(s): Mai Do, MD, DrPH; Bhavita Kumari, MD, MPH; Janine Barden-O’Fallon, PhD; Amani Selim, MA; Wezi Munthali, MPH; Bertha Migodi, MScCHN
Year: 2022
Language: English
Region(s): MALAWI